BONE RESPONSE TO PHOSPHATE SALTS, ERGOCALCIFEROL, AND CALCITRIOL IN HYPOPHOSPHATEMIC VITAMIN-D-RESISTANT RICKETS
BONE RESPONSE TO PHOSPHATE SALTS, ERGOCALCIFEROL, AND CALCITRIOL IN HYPOPHOSPHATEMIC VITAMIN-D-RESISTANT RICKETS
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DOI：
10.1056/nejm198010303031802
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发表时间：
1980-01-01
影响因子：
158.5
通讯作者：
DELVIN, EE
中科院分区：
文献类型：
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作者：
GLORIEUX, FH;MARIE, PJ;DELVIN, EE
患有维生素d抗性佝偻病的儿童（11）单独使用磷酸盐混合物（每天1.2-3.6 g）或与麦角钙化醇（维生素D2, 25-50倍）联合治疗。103 IU/天)或与骨化三醇（1,25-二羟基维生素D3, 0.25至1 μ g/天）。所有患者血清骨化三醇浓度均正常。骨化三醇治疗将循环激素水平提高到高于正常水平，并增加肠道磷酸盐吸收。在一些患者中，这种方案减少了对磷酸盐补充的需要。没有任何治疗方案纠正肾磷酸盐泄漏。放射学研究和骨组织形态学分析表明，磷酸盐（单独或与麦角钙化醇）诱导生长板矿化，但不诱导骨内表面矿化。骨化三醇与磷酸盐联合治疗2850患者日，可显著改善骨小梁矿化。改变骨化三醇的剂量可以很容易地控制短期高钙血症发作。骨化三醇和磷酸盐联合疗法对治疗维生素d抗性佝偻病是有用的。
Children (11) with vitamin D-resistant rickets were treated with a phosphate mixture alone (1.2-3.6 g per day) or combined with ergocalciferol (vitamin D2, 25-50 .times. 103 IU/day) or with calcitriol (1,25-dihydroxyvitamin D3, 0.25 to 1 .mu.g/day). Serum calcitriol concentrations were normal in all patients. Calcitriol therapy raised circulating levels of the hormone to values above normal and increased intestinal phosphate absorption. In some patients this regimen decreased the need for phosphate supplements. No treatment regimen corrected the renal phosphate leak. Radiologic studies and bone histomorphometric analyses showed that phosphate (alone or with ergocalciferol) induced the mineralization of the growth plate but not of the endosteal bone surface. Combined calcitriol and phosphate therapy for 2850 patient-days greatly improved the mineralization of trabecular bone. Short-term episodes of hypercalcemia were easily controlled by changes in calcitriol dosage. The combined calcitriol and phosphate regimen is useful in the treatment of vitamin D-resistant rickets.